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Case Report: A Severe Hypernatremia with Multiple Organ Failure, about a Clinical Observation

Open Journal of Nephrology 2017年第1期7卷 19-23页

作者： alpha oumar bah Mamadou Cellou Balde Amadou bah alpha oumar Barry Departement of Nephrology Donka National Hospital Conakry Guinea Departement of Nephrology-Hemodialysis Chiva Hospital Foix Cedex France Departement of Diabetology Donka National Hospital Conakry Guinea Departement of Reanimation Donka National Hospital Conakry Guinea

A hypernatremia severity is often associated with a poor prognosis, especially if it is associated with multiple organ failure. In a country with very limited resources, the prognosis may be favorable in the absence of renal replacement. We report the case of a 63 years old woman, hypertensive and diabetic, admitted to the ICU for unconsciousness. Clinically, neurological examination notes a Glasgow of 8/15 (Y2, V2, M4) and a left hemiplegia. Temperature was 39°C. Diuresis was 100 ml during the first 24 hours. Blood pressure was 90/60 mmHg, tachycardia at 133/min. Cardiac auscultation is normal. Vascular axes were weakly perceptible. Oxygen saturation was 95%. The skin examination notes a dry skin and mucous membranes, a flattening of the superficial veins, sunken eyes and a persistent skin fold. There is no hepatomegaly or splenomegaly, or jaundice. Biological point of view note natremia: 176 mmol/L;osmolarity: 390 mosmol/kg;creatinin: 300 μmol/L;glycemia > 6 g/L;transaminases 217 UI. Diagnostics: malignant hypernatremia with a high plasma osmolarity associated with an acute anuric renal failure, hydro electrolytic disorders, an abnormal liver function, a fever of central origin and a stroke. The treatment consisted of a correction of the electrolyte disorders by infusion of isotonic and hypotonic fluids with insulin. In a country with very limited resources, the severe hypernatremia prognosis associated with anuric acute renal failure may be favorable in the absence of renal replacement.

关键词： Hypernatremia Hyperosmolar Coma Multiple Organ Failure Acute Renal Failure Diabetes

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Soldiers’ Hypertension Prevalence in Military Garrisons in the City of Conakry

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Open Journal of Nephrology 2016年第4期6卷 132-137页

作者： alpha oumar bah Mamadou Foinké bah Fatoumata Binta Fofana Mariama Beavogui Departement of Nephrology Donka National Hospital Conakry Guinea Departement of Armies’ Health Conakry Guinea Departement of Cardiology Ignace Deen National Hospital Conakry Guinea

High blood pressure (HBP) is a public health problem worldwide. The objective of this study is to determine the prevalence of hypertension in military garrisons in Conakry, the capital. Material and Methods: The study was done in military garrisons. The data concern 1025 soldiers. This prospective and cross-sectional study took place from 13 November 2014 to 13 February 2015. Only the military who had agreed to participate in the study were included. Sociodemographic, clinical data and urine dipsticks were collected. Results: Among 1025 soldiers, 222 cases of HPB were observed, that was 21.66%. They were 193 men (86.94%) and 29 women (13.06%). The mean age was 46.05 years (range: 18 - 77 years). HPB cases were discovered in 155 soldiers (69.82%) in random observations. Following the grade of hypertension: 124 were of grade I, 62 of grade II, 35 of grade III and 1 case of isolated systolic hypertension was identified. Urinary dipstick tests showed that, 3 patients had proteinuria, 26 patients suffered from leucocyturia, 11 patients suffered from glycosuria and 1 case of hematuria was also identified. More than half of the soldiers (41%) were in the army. Officers were strongly affected (80.18%), followed by non-commissioned officers (17.12%) and finally enlisted men (2.70%). Risk factors were multiple: 78.82% ate very salty food;emotional stress;physical inactivity was observed in over half of the cases. Conclusion: This study gives an overall picture of the prevalence of hypertension in the military in Guinea. The discovery of the symptom lies on the systematic measurement of blood pressure.

关键词： High Blood Pressure Military Prevalence Conakry

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Late Nephrology Case Management and Morbidity Due to Chronic Renal Failure, Case of Guinea

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Health 2016年第9期8卷 805-812页

作者： alpha oumar bah Mamadou Saliou Balde Oury Baïllo Diallo Oumou Kimso Department of Nephrology Donka National Hospital Conakry Guinea

Context and Object: Late nephrology case management for patients with chronic renal failure is consistently associated with high morbidity rate. The objectives of this study were to determine the factors associated with late nephrology case management and to describe the evolution of patients depending on the time of care nephrology. Material and Methods: It was a 5-year prospective study, observational type, going from January 1st, 2010 to December 31th, 2014. We studied all the patients hospitalized with chronic renal failure with dialysis or not and we excluded the patients hospitalized for acute renal failure. Results: The study population includes 307 men (53.4%) and 268 women (46.6%) with a sex ratio of 1.14. Age population ranged between 15 and 85 years old with a mean of 44.4 ± 16.20 years old. Their profession was distributed as follows: 220 housewives (38.3%), 181 workers (31.5%), 104 civil servants (18.1%), 56 students (9.7%) and 14 unemployed (2.4%). Patients came from all regions of the country: Conakry: 389 patients (67.6%);Lower Guinea: 82 (14.3%);Middle-Guinea: 57 (9.9%);Upper Guinea: 31 (5.4%);Guinea Forest Region: 16 (2.8%). In this study population, 48 patients were admitted in emergency (8.3%);105 were scheduled (18.3%) and 422 were referred to the nephrology department (73.4%). Reasons for the emergency admission were acute pulmonary edema in 21 patients (43.7%), decompensated anemia in 13 patients (27.1%), loss of consciousness in 9 patients (18.7%) and malignant hypertension in 5 patients (10.4%). The reference patterns was uremic syndrome in 312 patients (54.3%), followed by high blood pressure in 247 patients (42.9%), an edematous syndrome in 234 patients (40.7%), oligoanuria in 222 patients (38.6%), morphological abnormalities on the renal ultrasound in 4 patients (0.7%). The functional symptoms were vomiting in 379 patients (65.9%), followed by dyspnea in 290 patients (50.4%), headaches in 287 patients (49.9%). Among them, 121 patients cou

关键词： Chronic Renal Failure Management Morbidity Donka National Hospital Conakry

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Frequency of the Cardiovascular Complications during the Chronic Renal Insufficiency with the Service of Nephrology of the National Hospital Donka

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World Journal of Cardiovascular Diseases 2020年第7期10卷 425-431页

作者： Fousseny Diakité Mamadou Saliou Baldé Ibrahima Sory Barry Moussa Traoré alpha Boubacar bah Fenela Mipimbou Mohamed Lamine Kaba alpha oumar bah Unit of Nephrology-Hemodialysis of the National Hospital Donka Guinea Unit of Cardiology of the National Hospital Ignace Deen Guinea

Introduction: Cardiovascular disease has become a major concern for the nephrologist as it is the leading cause of morbidity and mortality in patients with chronic kidney disease, and affects all stages of the disease, including the earliest stages of the disease. The goal of this work was to determine the frequency of cardiovascular complications during chronic kidney failure. Patients and methods: This was a six-month, descriptive cross-sectional study from March 01 to August 31, 2018. It covered all patients with chronic kidney disease hospitalized in the ward during the study period. Included were all chronic kidney failure patients with at least one cardiac and/or vascular complication diagnosed either on clinical examination, and/or paraclinical examination (Electrocardiogram or cardiac ultrasound, vessel echodoppler, scan). Results: During the study period, 84 out of 378 patients or 22.22% had at least one cardiovascular complication. Cardiovascular complications were hypertrophy of the left ventricle with 49/84 (44 at Electrocardiogram and 5 at cardiac echodoppler), valvulopathy with 33.33%, stroke with 50% of cases, obliterating arterial disease of the lower limbs 25%, hypokinetic dilated cardiomyopathy with 9/36 cases and pericarditis with 2/36. Conclusion: Cardiovascular complications affect both sexes and all ages. They were dominated by enlarged left ventricle, valvulopathy and dila

关键词： Cardiovascular Complications Chronic Kidney Failure Donka Conakry

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Intradialytic Hypertension and Associated Factors in Chronic Hemodialysis at the National Hemodidiadiasis Center in Donka, Guinea

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Open Journal of Nephrology 2020年第1期10卷 34-42页

作者： Fousseny Diakité Mamadou Saliou Baldé alpha Koné Moussa Traoré Ibrahima Chérif alpha Boubacar bah Mohamed Tassilmy Diaby alpha oumar bah Mohamed Lamine Kaba Nephrology-Hemodialysis Service Donka National Hospital Conakry Guinea Service of Cardiology National Hospital of Ignatius Deen Conakry Guinea

Introduction: Dialytic high blood pressure (DHBP), although often ignored, is now recognized as a recurring and persistent phenomenon in a subgroup of hemodialysized patients. Its occurrence is associated with an increased risk of hospitalization and death. The objective of the study was to determine the prevalence of intradialytic hypertension and the factors associated with it. Methods: Study was cross-sectional, monocentric, descriptive and analytical over a three-month period from April 22 to July 22, 2019. Included were all patients 18 years of age or older, chronic hemodialysis for at least three months, with intra-dialytic high blood pressure. The blood pressure machine used for the majority of patients was an electronic “OMRON” blood pressure monitor. Epidemiological, clinical, para clinical and dialysis parameters were studied. The data were collected, captured and analyzed using IBM SPSS Statistics Version 20 software. The factors associated with intradialytic high blood pressure were searched using a univariate logistic regression model. The significance threshold for all statistical tests has been set at 5%. Results: Of our 131 patients, 53 had intradialytic hypertension, a frequency of 40.5%. The time of (DHBP) occurrence was more frequent at the 3rd and 2nd hour, 94.34% and 86.79%, respectively. The average age of patients was 45.51 years with extremes ranging from 19 to 70 years. The average Systolic Blood Pressure (SBP) before dialysis was 148 mm Hg ?16.62 and the average Diastolic Blood Pressure (DBP) before dialysis was 88 mm Hg ?12.50. Pre-dialysis Blood Pressure—140/90 mm Hg was noted in 18 cases, or 34.0%. The intradialytic average SBP was 164 mm Hg ?17.25 with extremes of 121 to 202 mm Hg. The intradialytic average DBP was 92 mm Hg ?12.52 with extremes 67 to 124 mm Hg. The main risk factors associated with intra-dialytic hyperation were: Age range (40 - 50 years), Duration on dialysis (Conclusion: This study, the first of its kind in Guinea, wa

关键词： Risk Factors Intradialytic Hypertension Donka Guinea

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Obstetrical Acute Kidney Injury: Epidemiology and Clinical Aspects in Teaching Hospital of Ignace Deen, Conakry Guinea

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Case Reports in Clinical Medicine 2020年第1期9卷 35-39页

作者： Ibrahima Koussy bah Fousseny Diakite Mamadou Saliou Baldé Abdouramane Diallo Mamadou Yacine bah Amadou Yaya Diallo alpha Boubacar bah Moussa Traore Telly Sy Diallo alpha oumar bah Unit of Gyneco-Obstetric of the National Hospital Ignace Deen Conakry Guinea Unit of Nephrology-Hemodialysis of the National Hospital Donka Conakry Guinea

Introduction: In Guinea, data on the acute kidney injury (AKI) of women in the obstetrical context is still limited. This study attempted to determine the prevalence and the clinical signs of obstetric AKI in Guinea. Patients and methods: The study population consisted of pregnant or postpartum women with AKI, whom we treated in this institute from August 2018 to January 2019. All had normal anterior renal function with serum creatinine clearance ≥ 120 μmol/L, and then suffered AKI. Patients characteristics were examined;maternal age, gestational weeks, AKI characteristics. Results: Of 2438 pregnant women admitted during the study period, 56 showed AKI. Antepartum and postpartum AKI accounted for approximately 80% and 17%, respectively. Regarding the maternal age, Conclusion: We here demonstrated peripartum AKI in Guinea, which findings may provide fundamental data to establish some strategy against this condition in this region.

关键词： Obstetric AKI Epidemiological and Clinical Aspects Ignace Deen Conakry

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Causes and Prognosis of Cases of Acute Obstructive Renal Failure Managed at the Donka National Hemodialysis Center

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Open Journal of Nephrology 2024年第2期14卷 136-146页

作者： Amadou Yaya Diallo Mamadou Mouctar Diallo Mamadou Dian Barry Kadiatou Mamadou Bobo Barry Saikou oumar Diallo Djenabou Diallo Soriba Bangoura Mamadou Malal Diallo Thierno Mamadou Oury Diallo Mohamed Lamine Kaba alpha oumar bah Department of Nephrology-Hemodialysis CHU Donka Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of the Republic of Guinea Conakry Guinea Department of Urology-Andrology CHU Ignace Deen Conakry Guinea

Introduction: Acute obstructive renal failure (AORF) is a frequent clinical situation, secondary to obstruction of the urinary excretory tract. Whatever the cause, urinary tract obstruction suddenly opposes glomerular filtration and is responsible for tubulointerstitial lesions. It accounts for 10% of acute renal failure (ARF). The aim of this study was to identify the causes and prognosis of cases of acute obstructive renal failure managed at the Centre National d’hémodialyse Donka. Material and Methods: This was a prospective descriptive study lasting 6 months, from September 1, 2022 to February 29, 2023. All patients undergoing haemodialysis for acute obstructive renal failure who agreed to participate in the study and whose medical records were complete were included. Results: During the course of the study, we registered 97 haemodialysis patients, including 20 cases (20.62%) of acute obstructive renal failure. The mean age of the patients was 57.8 ± 10.54 years, with a male predominance of 11 cases (55%) and a sex ratio of 1.22. The reasons for consultation were dominated by physical asthenia 11 cases (55%), lumbar pain 9 cases (50%), vomiting 6 cases (30%) and acute urine retention 6 cases (30%). Arterial hypertension 16 cases (80%) and urinary tract infection 10 cases (50%) were the most common antecedents. The etiologies of RAOI were dominated by lithiasis 10 cases (50%), neoplasia 6 cases (30%) and benign prostatic hypertrophy 3 cases (15%). mean creatinine was 1267.60 ± 710.76 μmol/l with extremes of 243 μmol/l and 2822 μmol/l, mean urea was 39.56 ± 18.36, hyperkalemia in 14 cases (70%) and hyponatremia in 8 cases (40%). After hemodialysis, 9 cases (45%) recovered renal function, 4 cases (20%) became chronic and 7 cases (35%) died. Conclusion: The frequency of AKI remains non-negligible in our department, and early detection and prompt management would considerably reduce the morbidity and mortality associated with this pathology.

关键词： Acute Obstructive Renal Failure Hemodialysis Prognosis Donka

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Causes and Prognosis of Cases of Acute Obstructive Renal Failure Managed at the Donka National Hemodialysis Center

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Open Journal of Nephrology（肾脏病） 2024年第2期 136页

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Psychosocial Aspects of Male Infertility at the Service of Urology-Andrology of the Hospital of the Sino-Guinean Friendship

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Open Journal of Urology 2024年第7期14卷 400-406页

作者： Alimou Diallo Thierno oumar Diallo alpha oumar Barry Ibrahima bah Abdoulaye Bobo Diallo oumar Raphiou bah Urology Department of the Hospital of the Sino-Guinean Friendship Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea Urology Department of National Ignace Deen Hospital Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea

Objective: Describe the psychosocial aspects of male infertility at the hospital of the Sino-Guinean Friendship. Patients and method: It is a prospective study of a descriptive type covering a period of 6 months. The study covered 17 patients, all received for a desire to conceive after at least one year of regular sexual intercourse without contraception. The data were collected from patient interviews using a pre-established questionnaire. Results: The average age of the patients was 32.07 years with extremes of 23 years and 42 years. During this study, 64.70% of patients were no longer participating in community ceremonies. The patients’ relationships with their spouse and family deteriorated in 52.94% and 47.06%, respectively. Conversely, relations with the family of origin remained unchanged in 70.59 percent of cases. The reduction in economic activity was by 13 patients (76.48%). Conclusion: Male infertility causes a real psychic earthquake in men with its corollaries of negative feelings. The rather complex moral repercussions of male infertility affect not only the individual, his/her partner, and family, but also economic activity.

关键词： Male Infertility Psycho-Social Aspect Psychic Earthquake

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Urogenital Complications of Groin Hernia Surgery: A Multicentre Study in Guinea

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Open Journal of Urology 2024年第3期14卷 173-178页

作者： Alimou Diallo Karifa Oulare alpha oumar Barry Thierno oumar Diallo Daouda Kanté Ibrahima bah Abdoulaye Bobo Diallo oumar Raphiou bah Department of Urology Sino-Guinean Friendship Hospital Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Urology National Ignace Deen Hospital Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea

Context and Objective: Groin hernia is a common pathology in visceral surgery (2nd rank after appendicitis), which affects approximately 4.6% of the African population. Restoring the normal anatomy of the groin region is one of the most benign interventions. However, uro-andrological complications are possible. This study aimed to contribute to the improvement of the management of urogenital complications of groin hernia surgery. Patients and Method: We carried out a prospective study of descriptive type with a duration of 6 months from 1 August 2021 to 31 January 2022. The data were collected using a pre-established survey sheet. The study covered several sites (public hospitals and private clinics) in Guinea. Results: The urogenital complications of the surgery of the hernia of the groin represented 15.22% or 14 cases out of 92 patients. The average age was 37.00 years with extremes of 20-69 years. Polygamists occupied the first place. The reason for consultation was dominated by decreased testicular volume (42.86%), followed by a desire to conceive (21.43%). Unilateral testicular atrophy represented 63.64%, bilateral 27.27%. We performed a left orchidectomy in one patient and a cystorraphy in another simple operative follow-up. The other cases consisting of testicular atrophy, due to lack of a suitable technical platform, did not benefit from any specific therapeutic treatment. Conclusion: Urogenital complications of groin hernia surgery are relatively common. Testicular atrophy was the main clinical complication. The left orchidectomy and cystorraphy were the therapeutic procedures performed.

关键词： Hernia of the Groin Herniorraphy Testicular Atrophy Orchidectomy Cystorraphy

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